Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 137730 | CA |
NPI | 1083090781 |
---|---|
Provider Name | Dr. Laurence Paek |
First Address | Stanford, CA 94305-2200 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2015 |
Last Update Date | 17/08/2015 |